title: Fulminant amoebic colitis: a rare fierce presentation of a common pathology.
abstract: We conducted a retrospective study of patients with fulminant amoebic colitis (FAC) over a 20 year period in an urban tertiary care hospital in Pakistan. After consideration for inclusion and exclusion criteria 25 cases were identified as FAC with the most common presentations being abdominal pain (84%). Nineteen (76%) underwent laparotomy for peritonitis with evidence of: colonic perforation in 10 (40%); faecal peritonitis in eight (32%); bowel gangrene in one (4%); and intra-abdominal abscess in two (8%). Nine (36%) deaths were recorded in the series - eight (53%) in the operated group and one (16.6%) in the medically-treated group. The optimal outcome can be achieved in FAC with aggressive resuscitation, intravenous broad-spectrum antibiotics, including metronidazole, and total colectomy without anastomosis in patients with peritonitis.
authors.affiliation: Department of Surgery, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi 74800, Pakistan. rehman.alvi@aku.edu
authors.forename: Abdul Rehman
authors.initials: AR
authors.lastname: Alvi
authors.forename: Ahmed
authors.initials: A
authors.lastname: Jawad
authors.forename: Fariha
authors.initials: F
authors.lastname: Fazal
authors.forename: Raza
authors.initials: R
authors.lastname: Sayyed
mesh_terms: D018784:Abdominal Abscess / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004404:Dysentery, Amebic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult
keywords: Fulminant colitis; amoebiasis; amoebic colitis